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| Loch, stock & barrel lochstockandbarrel@yahoo.com 816-805-7844 Order form Customer name:_________________________________________________________________________ Address:_______________________________________________________________________________ City, state, zip:____________________________________________________________________________ Phone:_________________________________________________________________________________ e-mail:_________________________________________________________________________________ Item ordered:____________________________________________________________________________ Color/Tartan:_____________________________________________________________________________ Measurements: (A)_______(B)_______(C)_______(Chest - for shirt)_________________________________ Options:_________________________________________________________________________________ Cost:____________________________________________________________________________________ Payment Method: Cash _____ USPS M.O. _____ Cashier's Check _____ Personal Check ____ Credit Card ____ Credit Card Type: VISA______________________ MasterCard_____________________ Card Number:___________________________________________Expiration Date_______________________ Credit Card Security Code (the 3 numbers on the right or the signature block on the back) ___________________ NOTE: We cannot process your card without this number SPECIAL INSTRUCTIONS: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ We are in the process of updating this website, and are unable to complete this form online. Please copy or print it, complete it, the scan and e-mail it, send it by regular mail (Loch, Stock and Barrel, 6231 Rockhill Rd, Kansas City, Missouri 64110), or call us. Thanks for your patience! |
lindaneal@lochstockandbarrel.com 816-805-7844
Order Form